Have you Heard of GERD? (Of Course You Have)
Approximately 6 out of 10 adults in the United States suffer from gastroesophageal reflux disease, also known as GERD, and 3 in 10 experience symptoms on a weekly basis. The most common symptoms are a burning sensation in the chest or throat and a sour taste in the mouth, but others exist: difficulty swallowing, sore throat, hoarseness, dry cough, regurgitation, the sensation of a lump in the throat, and even chest pain.
The most common treatment for GERD is medication that targets stomach acid in 1 of 3 ways:
- Antacids like Maalox, Mylanta, Gaviscon, Rolaids, and Tums neutralize stomach acid.
- H2 blockers like Zantac, Pepcid, and Tagamet reduce the production of stomach acid indirectly by inhibiting the activity of histamine.
- Proton pump inhibitors (PPIs) like Nexium, Prevacid, Prilosec, and Protonix reduce levels of stomach acid directly by blocking the final step of acid production.
These drugs are not always well tolerated. Side effects may include nausea, vomiting, diarrhea, flatulence, headache, and dizziness. PPIs have also been associated with an increased risk of bone fractures, pneumonia, and dementia, and there are concerns about an increased risk for cardiovascular events, especially when these drugs are used in combination with other drugs.1
Furthermore, reducing the production of stomach acid can have dangerous consequences. When our stomachs are not acidic enough, we don’t absorb certain nutrients very well and may develop deficiencies of vitamins like B12 and minerals like calcium, magnesium, zinc, and iron.2 Low stomach acid also causes imbalances in the microorganisms that inhabit our bodies. It promotes bacterial overgrowth in the stomach and small intestine (SIBO) and makes us more vulnerable to infection from food-borne bacteria, bacteria that produce chemicals (nitrosamines) linked to stomach cancer, and antibiotic-resistant bacteria like C. difficile.3
Acid-reducing Drugs are Intended to be Used for Weeks, not Forever
Acid-reducing drugs are intended to be used for only 8 weeks, but people often use them longer or even indefinitely. The longer these medications are used, the more difficult it is to stop using them because cessation can have a rebound effect, triggering a sudden increase in stomach acid production and a severe aggravation of symptoms. These drugs, particularly PPIs, should never be discontinued without a doctor’s supervision.
In some cases, like those involving ulcers, drugs that reduce stomach acid production may be necessary for healing to happen. But in many cases, their risks outweigh their benefits because GERD is not caused by too much stomach acid. It’s caused by incomplete closure of the valve that separates the stomach from the esophagus. Every time you swallow, a doughnut-shaped muscle called the lower esophageal sphincter or LES relaxes to open the passage, allowing food and liquid to travel from the esophagus into the stomach. Then it constricts to tighten back up again, closing the passage to keep the contents of the stomach inside the stomach.
When the LES isn’t tight enough, acid from the stomach can travel up into the esophagus where it causes inflammation and damages delicate tissues that were never meant to encounter an acidic environment. If this happens over and over, inflammation in the esophagus can become chronic and may lead to bleeding and narrowing. Chronic esophageal inflammation also increases the risk of developing esophageal cancer.
To treat the real cause of GERD and reduce the risk of cancer, it’s important to tighten the LES, heal inflamed tissue in the esophagus, and maintain good digestion. Tightening the LES stops reflux and healing the esophagus resolves inflammation and discomfort. Digesting our food fully is important because when it’s not properly broken down, it lingers too long in the stomach and puts pressure on the LES, making it less likely to stay tightly closed.